Fraught with contradiction, heels paradoxically inhibit movement in order to increase it, at least in appearance. Standing in heels, a woman presents herself already half-walking while at the same time reducing the length of her step, fostering the illusion of speed while suggesting the promise of an imminent fall.

David Kunzle, Fashion and Fetishism: Corsets, Tight-Lacing, and Other Forms of Body-Sculpting (2006)

Petite Florentine noblewoman Catherine de Médicis started the fashion for high heels back in 1533 when she wore them for her marriage to the Duke de Orléans. High-heeled shoes give the optical illusion of a longer, slimmer leg, a smaller foot, and overall greater height. They alter the wearer’s posture and gait, flexing the calf muscles and making the bust and bottom more prominent. When a woman wears high heels (defined as shoes with a heel two inches or higher) her foot slides forward, forcing the toes into the unnatural shape of the shoe and redistributing her weight incorrectly.

High heels force a woman’s foot into the vertical posture described by Alfred Kinsey in Sexual Behaviour in the Human Female (1953) as typical during female sexual arousal, when “the whole foot may be extended until it falls in line with the rest of the leg.” The increased weight on her toes causes her body to tilt forward, and to compensate; she leans backwards and overarches her back, creating a posture that can strain her knees, hips, and lower back. The change to the position of her spine puts pressure on nerves in the back and can cause sciatica, a condition where nerves become trapped, triggering pain and numbness as far down as the feet.

Despite their impracticality, the popularity of high heels remains undiminished nearly 500 years after Catherine de Médicis first created a stir at the French court.

More than three million British women have had to seek medical attention for injuries caused by their high heels.

One in 10 women wear high heels at least three days a week and a third have fallen while wearing them.

Wearing high heels for prolonged periods can lead to spinal misalignment, shortened calf muscles and osteoarthritis. A 2013 study conducted by the College of Podiatry found that nearly 20 million British women have foot conditions caused by wearing high heels, such as joint pain, hammer toes, bunions, neuroma and ankle injuries.

The study was based on a survey of 2,000 British men and women and 60 podiatrists and chiropodists. More than a third of respondents said their feet had been so sore on a night out that they danced shoeless and walked home barefoot. The study found that the younger the woman, the higher their heels. Roughly 20% of those aged 18-24 own a pair of six-inch high-heels. This compares with 10% of those aged 25-34 and just 3% of 35-44 year olds.

Rupert Evans, an accident and emergency doctor at University Hospital of Wales in Cardiff says he has seen an increase in the number of women being admitted to hospital with high-heel related injuries. Martin Shalley, British Association for Emergency Medicine says that high heel related injuries range from sprained ankles to broken bones and dislocations, and estimates that up to half a dozen women are being admitted to his department with shoe-related injuries on weekend evenings. Consultant podiatrist Mike O’Neill, says ‘Any shoes with a heel higher than two inches are a concern.’ Rupert Evans, agrees, and advises that women should stick to shoes with heels less than 4cm (1.5in) if they want to avoid a trip to hospital.

1n 2010, college student Megan Moore (16) was killed instantly when she slipped in her high heels as she ran along a rail platform and fell under a train in Worthing, West Sussex. Megan had been drinking vodka and Red Bull with her best friend Sara Yos earlier in the evening and was running alongside Sara’s train, waving goodbye to her, when she plunged down the gap between the carriage and the platform. Recording a verdict of accidental death, West Sussex coroner Penelope Schofield said: ‘Nobody could have prevented this type of accident. It shows what happens when young people consume such an amount of alcohol and I hope that other young people can learn from this tragic case.’

In 2012, Georgia Varley (16) was killed instantly when she fell under the wheels of a moving train because the guard gave the order to set off as she leaned, intoxicated against the carriage at Liverpool’s James Street Station. The court heard the sixth form student had earlier been at a house party for a friend’s 18th birthday where she had drunk vodka and was said to be ‘the drunkest person at the party’. The guard who signalled for the train to set off, Christopher McGee (45) appeared in Liverpool Crown Court charged with manslaughter.

In 2013, Antoinette Sackett-Wood (39), a woman who was wearing high heels for ‘the first time in years’ died from a blood clot after falling and breaking her ankle, an inquest heard. Ms Sackett-Wood, from Snodland, Kent, was on a night out when she slipped over and hurt her ankle last December.Neighbour Tony Parris said he saw Ms Sackett-Wood on crutches soon after her fall. When he asked what had happened, she blamed the heels.Ms Sackett-Wood was obese and suffered with brittle bones, the court heard. Assistant deputy coroner Allison Summers recorded a death by natural causes.

In 2014, I carried out an anonymous online survey of 100 British women. I asked,

Have you ever had an accident because of wearing high-heeled shoes?

Yes – 41.67%

No – 58.33%

Women’s visits to the doctor for foot and toe complaints shot up 75% between 2005 and 2009, but although twice as many women as men report suffering from corns, cracked heels and bunions caused by wearing uncomfortable and ill fitting shoes, 20% of the women surveyed by the College of Podiatry did not seek medical help because they believed their foot complaint was not important.

Consultant podiatrist Mike O’Neill, from the College of Podiatry, warns that squeezing feet into smaller shoes can cause long-term damage including arthritis, stress fractures, and trapped nerves, which may even require surgery or steroid injections. O’Neill says, ‘There’s absolutely no doubt women who wear high heels are putting themselves at risk of permanent injury in the name of fashion. Given a choice between a stylish pair of shoes or nice feet, many will go for the stylish shoes.’

I asked [of the 41.67% of my survey group who had had an accident because of wearing high heels],

Did the accident require further medical treatment, i.e. a visit to your GP or hospital?

Yes – 16%

No – 84%

The third question in my survey was optional,

Please describe the shoes and the incident.

The following quotations are the answers I received.

Tripped, fell flat on my face, probably more due to being tipsy, but cobbles and high heels helped just as much. Skinned knees, bruised face.

Wooden platforms purchased in Berlin, was wearing at a house party when I stumbled and grabbed hold of the nearest thing to me, which happened to be the record decks, I landed on the floor, with record deck on top of me.

Brown platforms with high stacked heels and cream piping (like icing). Fell over just about every time I wore then. Once I waved at my date who was standing by the fountain in Kelvingrove, and promptly fell over and skinned both knees. Had to buy cotton wool and a pair of American Tan tights in a shop in Argyle Street.

2 inch high Mary Janes – slipped on leaves coming down steps and sprained both ankles. I’m a very amateur ‘high’ heel wearer.

Fell down flight of stairs

5 inch high stilettos with one inch platform. Lost footing walking down stairs and hit head against wall at the bottom.

I am an infrequent heel wearer, so was only wearing about a 1&1/2 inch heel. I was novelty struck and spinning on the heel at a friends wedding, a few glasses of wine in, but not lots. I spun my way exuberantly across the dance floor, became entangled in the bride’s dress and landed on the floor at her feet. She was very nice about it- but I did tear the dress a bit and had to be unraveled while everyone watched. I still occasionally wear a wee heel but take greater care. I was mortified, but we all see the funny side now. I really hope so anyway.

7 inch platforms, fell down the stairs. Huge bruise and bad ankle for about a year.

There are many incidents, but 30th birthday, very high Vivienne Westwood plastic lobster heels, pink, fell over at least three times due to a) the fact that they are very high and hard to walk in b) drinking an obscene amount of cava.

In rural Spain I walked down a kind of mud road in the dark, in high heels. I stumbled and flew through the air and landed awkwardly and so broke my ankle, I could hear it crack.

High-heeled shiny black stilettos. I was running up some stairs at work (in a theatre) fell forward and smashed my nose. Also had many other various trips and slips over the years…

Low-heeled (1.5 inches), fairly ‘practical’ vintage black shoes. Wore them to work & heel broke outside building sending me flying head first into a puddle. Scratched my cheek, but otherwise was ok.

I sprained my ankle while wearing high ankle strapped sandals

High stiletto, went over on the side, fell over, sprained my ankle!

Shoes: Borrowed from a friend, too high for me! Incident: Sore feet and a twisted ankle.

Cheap wedge sandals plus uneven pavement resulted in a semi-fall. Ego bruised as much as ankle.

Red strappy sandals. Went over on my ankle, ouch.

I sort of don’t know what happened, but I caught the heel of the shoe on a doorframe, and as I tumbled I sort of caught the heel on my other leg and stabbed myself a bit. It was crap.

Confident, sometimes tall like I’m wearing something for the ‘pleasure’ of others. I no longer buy or wear them.

Uncomfortable! Hot, dressed up, like I’ve made an effort, uncomfortable, more exposed, like I’m seeking attention

Taller and more elegant. Also, sore and constrained. I don’t wear them often.

Taller and thinner a bit useless.

Tall at first but tired soon after Self-aware, in every sense…

Like I can kiss my husband without needing a lift! Clumsy, but they I like them too sometimes…they can feel very beautiful. Mostly I feel ridiculous and I’ve never found a comfortable pair. They do help me feel more powerful in terms of my sense of presence especially as a small woman. Taller taller and more important / wobbly and blistered. To me a high heel is 2 inches / 6 cms high – anything over is a dead trap.

Sexy but have a sore back

Uncomfortable, but like a different person Restricted. I used to wear them ALL the time – now I feel they slow me down. Elegant and sexy happy… like a man in drag.

Intimidating ‘dressed’ tall

Slimmer

Powerful, glamorous, confident, referencing other powerful, glamorous women and at other times, overdressed, overly feminised, vulnerable. More professional and smart (I’m a lecturer), but only if they’re comfy & relatively low-heels (I can only do 2.5 inches max). Higher heels make me feel clumsy, restricted (e.g. I can’t run for a bus in them) and like I’m a kid pretending to be a grown up. I seriously envy those that can walk comfortably in them though.

Like a drunk daddy-long-legs. I really hate them. They make me feel stupid. Taller, slimmer, bit self-conscious, sometimes more attractive, sometimes more ungainly.

A bit taller, sometimes more sophisticated but sometimes a bit silly.

Too tall and slightly unsteady when walking. If I stood still for the duration, I know high heels would compliment my outfit and make my ankles look more elegant.

Clumsy restricted. Achey and uncomfortable.

Grown up and businesslike …dressed up for a special occasion …like I want to take them off after 10 minutes!

Sophisticated, smart and confident! Elegant, strong, and sometimes awkwardly tall. pretty uncomfortable. For a start I have massive feet, so any high heels I own are a little bit small for me. So they get sore quickly. That means that I don’t wear them very often, but when I do I feel a bit odd. High heels are shoes that one shouldn’t wear when you feel odd because you have to be confident and not odd. I therefore have formed the opinion that I shouldn’t wear them.